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[The health system in Japan and France]
1Département de l'Administration sanitaire, Faculté de Médecine, Université de Tokyo, Japon.
Abstract:
In 1987, male life expectancy at birth rose to 75.6 years in Japan, but reached only 72 years in France. Nevertheless, per capita health expenditures were lower in Japan (6,074 French francs in 1986) than in France (6,721 French francs in 1986). This does not imply that the Japanese health system is "economic" at all levels. The average annual hospital stay (in short-term hospitals) in 1986 rose to 39.7 days in Japan, as compared to 13.6 days in France. Per capita consumption of pharmaceuticals in 1987 was US$ 208 in Japan, compared to US$ 136 in France. These differences come from two specific Japanese features. Japanese physicians (most of whom are in private practice, as are their French and American colleagues) are allowed to have beds in their office and to hospitalize their patients there. Consequently, the number of beds and the average hospital stay are much higher in Japan. Secondly, Japanese physicians can give pharmaceuticals directly to their patients, which raises pharmaceutical consumption considerably. Needless to say, the results obtained currently by the Japanese health system are extremely positive. This is probably due to the fact that nowadays the Japanese have succeeded in integrating the advantages of the Westernization process (hygiene, eradication of infectious diseases, etc.) without adopting its disastrous aspects (for example, unhealthy lifestyles). However, this is simply an assumption for the time being.